Removal of Obsolete Portion of Regulation Relating to Care and Treatment of Ineligible Individuals

Issuing agencies

Abstract

The Indian Health Service (IHS) of the Department of Health and Human Services (HHS or "the Department") is issuing this final rule to remove obsolete language appearing in the Code of Federal Regulations (CFR). The language refers to an outdated process for determining what the IHS will charge for care to non-IHS-beneficiaries. Eliminating this obsolete language will not change IHS's existing practices or authorities.

Full Text

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<title>Federal Register, Volume 91 Issue 194 (Thursday, October 8, 2026)</title>
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[Federal Register Volume 91, Number 194 (Thursday, October 8, 2026)]
[Rules and Regulations]
[Pages 64301-64302]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2026-20685]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Indian Health Service

42 CFR Part 136

RIN 0917-AA14


Removal of Obsolete Portion of Regulation Relating to Care and 
Treatment of Ineligible Individuals

AGENCY: Indian Health Service (IHS), HHS.

ACTION: Final rule.

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SUMMARY: The Indian Health Service (IHS) of the Department of Health 
and Human Services (HHS or ``the Department'') is issuing this final 
rule to remove obsolete language appearing in the Code of Federal 
Regulations (CFR). The language refers to an outdated process for 
determining what the IHS will charge for care to non-IHS-beneficiaries. 
Eliminating this obsolete language will not change IHS's existing 
practices or authorities.

DATES: This rule is effective on December 7, 2026.

FOR FURTHER INFORMATION CONTACT: Carl Mitchell, Director, Division of 
Regulatory and Policy Coordination, Office of Management Services, 
Indian Health Service, 301-651-0489 (This is not a toll-free number), 
<a href="/cdn-cgi/l/email-protection#b1f2d0c3dd9ffcd8c5d2d9d4ddddf1d8d9c29fd6dec7"><span class="__cf_email__" data-cfemail="195a786b753754706d7a717c75755970716a377e766f">[email&#160;protected]</span></a>.

SUPPLEMENTARY INFORMATION: HHS published a notice of proposed 
rulemaking in the Federal Register on June 15, 2020 (85 FR 36182), with 
a sixty-day comment period, which closed on August 14, 2020. HHS did 
not receive any public comments.
    HHS will remove outdated language appearing in the CFR at 42 CFR 
136.14(b). The regulations in this part established general principles 
and program requirements for carrying out Indian health programs. 
Regarding the provision of IHS services to ineligible individuals, 
Sec.  136.14(b) provides that such individuals should be charged 
``rates approved by the Assistant Secretary for Health and Surgeon 
General published in the Federal Register.'' The Assistant Secretary 
for Health and the Surgeon General no longer approve or publish such 
rates. The Agency therefore will remove this unnecessary language. When 
the outdated language of Sec.  136.14(b) is removed, Sec.  136.14 in 
its entirety will read: ``(a) In case of an emergency, as an act of 
humanity, individuals not eligible under Sec.  136.12 may be provided 
temporary care and treatment in Service facilities; (b) Charging 
ineligible individuals. Where the Service Unit Director determines that 
an ineligible individual is able to defray the cost of care and 
treatment, the individual shall be charged. Reimbursement from third-
party payors may be arranged by the patient or by the Service on behalf 
of the patient.'' For complete access to background documents or 
information, go to <a href="http://www.regulations.gov">http://www.regulations.gov</a> and search for Docket ID 
number IHS-FRDOC-0001.

Executive Orders 12866, 13563, and 14192

    Executive Orders 12866 and 13563 direct agencies to assess all 
costs and benefits of available regulatory alternatives. Section 3(f) 
of Executive Order 12866 defines a ``significant regulatory action'' as 
an action that is likely to result in a rule: (1) Having an annual 
effect on the economy of $100 million or more in any 1 year, or 
adversely and materially affecting a sector of the economy, 
productivity, competition, jobs, the environment, public health or 
safety, or state, local or Tribal governments or communities (also 
referred to as ``economically significant''); (2) creating a serious 
inconsistency or otherwise interfering with an action taken or planned 
by another agency; (3) materially altering the budgetary impacts of 
entitlement grants, user fees, or loan programs or the rights and 
obligations of recipients thereof; or (4) raising novel legal or policy 
issues arising out of legal mandates, the President's priorities, or 
the principles set forth in the Executive Order. A regulatory impact 
analysis must be prepared for major rules with economically significant 
effects ($100 million or more in any 1 year). The HHS submits that this 
final rule is not ``economically significant'' as measured by the $100 
million threshold, and hence not a major rule under the Congressional 
Review Act. This rule has not been designated as a ``significant 
regulatory action'' under Executive Order 12866. Accordingly, this rule 
has not been reviewed by the Office of Management and Budget (OMB). 
Executive Order 14192 requires that any new incremental costs 
associated with significant new regulations ``shall, to the extent 
permitted by law, be offset by the elimination of existing costs 
associated with at least ten prior regulations.'' This final rule is 
expected to be an Executive Order 14192 deregulatory action.

Regulatory Flexibility Act

    This action will not have a significant economic impact on small 
entities such as Indian health programs. Therefore, the regulatory 
flexibility analysis provided for under the Regulatory Flexibility Act 
is not required.

Paperwork Reduction Act

    This action does not affect any information collections.

List of Subjects in 42 CFR Part 136

    Care and treatment of ineligible individuals.

    For the reasons set forth in the preamble, the Department amends 42 
CFR part 136 as follows:

PART 136--INDIAN HEALTH

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1. The authority citation for part 136 continues to read as follows:

    Authority:  42 U.S.C. 2001 and 2003; 25 U.S.C. 13; and 25 U.S.C. 
1621a.

[[Page 64302]]


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2. Amend Sec.  136.14 by revising paragraph (b) to read as follows:


Sec.  136.14  Care and treatment of ineligible individuals.

* * * * *
    (b) Charging ineligible individuals. Where the Service Unit 
Director determines that an ineligible individual is able to defray the 
cost of care and treatment, the individual shall be charged. 
Reimbursement from third-party payors may be arranged by the patient or 
by the Service on behalf of the patient.

Robert F. Kennedy, Jr.
Secretary, Department of Health and Human Services.
[FR Doc. 2026-20685 Filed 10-7-26; 8:45 am]
BILLING CODE 4166-14-P


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